Post on 13-Jan-2016
description
Anatomi Jantung & Konsep dasar elektrokardiografi
THE HEART
Interventriculer Septum
Papillary muscle
Semilunar Valve
Anatomy of the HeartAnatomy of the Heart
Pericardium : Pericardium :
Outer fibrous sackOuter fibrous sack
Myocardium :Myocardium :
Thick muscle wallsThick muscle walls
Endocardium : Endocardium :
Innermost surfaceInnermost surface
EndotheliumEndothelium
Simple squamous Simple squamous
epitheliumepithelium
PerikardiumPerikardium
Perikardium Fibrosa
Lapisan paling luar rongga Pericardium
Menjaga kedudukan jantung di rongga mediastinum
Perikardium Serosa
Lapisan parietalis
Lapisan bagian dalam dari rongga pericardial
Lapisan visceralis / epicardium
Rongga Perikardium
Cairan pericardium
Mengurangi gesekan saat jantung bergerak
Anatomy of the HeartAnatomy of the Heart
Heart chambersHeart chambers ::
Left & right atriaLeft & right atria
Left & right ventriclesLeft & right ventricles
Heart valvesHeart valves ::
Atrioventricular valves :Atrioventricular valves :
Right : TricuspidRight : Tricuspid
Left : Bicuspid/MitralLeft : Bicuspid/Mitral
Semilunar valvesSemilunar valves
Right : Pulmonary valveRight : Pulmonary valve
Left : Aortic valveLeft : Aortic valve
Anatomy of the HeartAnatomy of the Heart
AortaAorta
Coronary arteriesCoronary arteries
ArteriolesArterioles
CapillariesCapillaries
VenulesVenules
Coronary sinusCoronary sinus
Right atriumRight atrium
Coronary circulationCoronary circulation
TipeTipe--tipetipe selsel OtotOtot JantungJantung
Autoritmik autoritmik mampu berdepolarisasi spontan
produce pacemaker potentials
menyalurkan aksi potensial ( impulses ) melewatimyocardium
tidak berkontraksi
Kontraktil Potensial aksi menimbulkan kontraksi
Aliran darah ditimbulkan oleh pergantian dari
kontraksi ( SISTOLIK ) dan Relaksasi ( DIASTOLIK )
Intrinsic Conducting SystemIntrinsic Conducting System
Sinoatrial nodeSinoatrial node
Electrical pace makerElectrical pace maker
Atrioventricular nodeAtrioventricular node
Receives impulses Receives impulses
originating from SA nodeoriginating from SA node
Bundle of HisBundle of His
Electrical link between Electrical link between
atria and ventriclesatria and ventricles
Purkinje fibresPurkinje fibres
Distribute impulses to Distribute impulses to
ventriclesventricles
Conduction System
SA Node Internodal branch AV Node Hiss Bundle Purkinje Fiber Contraction
Cardiac Action PotentialsCardiac Action Potentials
7/21/20107/21/2010 Dr Paul Bradley, Clinical Skills Resource Centre, University ofDr Paul Bradley, Clinical Skills Resource Centre, University of Liverpool, UKLiverpool, UK 1717
The chest leadsThe chest leads V1 V1 -- 4th ICS RSE4th ICS RSE V2 V2 -- 4th ICS LSE4th ICS LSE V3 V3 -- midway between V2 & V4midway between V2 & V4 V4 V4 -- 5th ICS MCL5th ICS MCL V5 V5 -- 5th ICS AAL5th ICS AAL V6 V6 -- 5th ICS MAL5th ICS MAL
V1 V2 V3 V4 V5 V6
Sternomanubrial joint - Angle of Louis
The Electrocardiogram ( ECG )The Electrocardiogram ( ECG )
P wave : atrial P wave : atrial depolarisationdepolarisation
QRS complex : QRS complex : ventricular ventricular depolarisationdepolarisation
T wave : ventricular T wave : ventricular repolarisationrepolarisation
Atrial repolarisation Atrial repolarisation hidden by QRShidden by QRS
P
Q
R
S
T
P Wave
GELOMBANG P
NormalTinggi : < 0,3 mvoltLebar : < 0,12 detikSelalu positif di L IISelalu negatif di aVR
KepentinganMengetahui kelainan di Atrium
Gelombang P Pulmonal
Gelombang P Mitral
Gambaran yang ditimbulkan oleh depolarisasi atrium
P Pulmonale
P Mitrale
PR Interval
Interval PRDiukur dari permulaan P s/d permulaan QRS
Normal : 0,12 - 0,20 detik
QRS Complex
GELOMBANG QRS
Gambaran yang ditimbulkan oleh depolarisasi ventrikel
Normal :Lebar : 0,06 - 0,12 detikTinggi : Tergantung lead
Normal gelombang QLebar : < 0,04 detikDalam : < 1/3 tinggi R
ST Segment
T Wave
AXIS AXIS AXIS AXIS AXIS AXIS AXIS AXIS
Right Axis DeviationRight Axis DeviationRight Axis DeviationRight Axis Deviation Left Axis DeviationLeft Axis DeviationLeft Axis DeviationLeft Axis Deviation
RADRADRADRADRADRADRADRAD
LADLADLADLADLADLADLADLAD
4343
ContohContoh EKG normalEKG normal
4444
ContohContohEKG NormalEKG Normal
4545
ElektrodaElektroda terbalikterbalik
4646
Dextrocardia : direkam biasa
4747
Cara merekam Dextrocardia